5. Ethanol Metabolism
One drink equals:
• 12 ounces beer
• 5 ounces wine
• 1.5 ounces distilled liquor
70 kg person metabolizes
approximately one drink/hour
7 calories per gram vs. fat @
9 calories/gm
6. Ethanol
Highest serum level recorded with full
recovery in an adult - 1510 mg/dL
Legal limit for intoxication - 80mg/dL or
0.08
Odor threshold - 10 ppm
7. Alcohol and Alcoholism
Ethyl alcohol
• Most commonly abused drug in U.S.
• 6,000,000 to 10,000,000 alcoholics
• 50% of fatal motor vehicle crashes
• 50% of violent deaths
• Contributes to pathology in 25-35% of all
hospital patients
8. Alcohol and Alcoholism
Alcoholism
• Addiction to alcohol or abuse of alcohol to
a degree that produces problems in one or
more of these areas:
– Health
– Social relationships
– Economic status
– Interpersonal relationships
9. Alcohol and Alcoholism
Phases
• Problem drinking
– Drinks to relieve stress
– Abstinence does not cause physical symptoms
• Alcohol addiction
– Abstinence produces physical symptoms
10. Alcohol and alcoholism
Alcohol does NOT depend on type of
EtOH
Alcoholism occurs in ALL social classes
and age groups
“Skid row bums” = 3 to 5% of alcoholics
11. Alcohol and alcoholism
Typical alcoholic
• Employed male
• “Social drinker”
• Drinks early in day
• Drinks alone or secretly
• Binges accompanied by
memory loss
• Unexplained GI upset,
bleeding
• Green-tongue syndrome
• Cigarette burns on
clothing
• Chronically flushed face,
palms
• Tremulousness, anxiety
with reduced intake
• Problems with family,
work, law enforcement
related to EtOH
16. Acute Overdose Treatment
DONT
• Dextrose, Oxygen, Narcan, Thiamine
• Glucose, thiamine (50-100mg)
• Narcan may reduce respiratory
depression but not CNS depression
(? Use)
Dialysis - removes 280mg/minute
17. Acute Alcohol Effects
Stupor-Coma
• Hypoglycemia
– Inhibition of protein to sugar conversion in
liver (gluconeogenesis)
– D-stick all patients with altered LOC
38. Abstinence Syndrome
Stages
• Hallucinations
– Distorted vision
– Misinterpretation of visual stimuli (snakes,
vermin)
– Auditory hallucinations
• Seizures (“rum fits”)
– Usually in first 24 hours
– Major motor seizures in bursts of 2 to 6
– May progress to status epilepticus
